NPI | 1790804193 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN E ROACH Executive Director 217-523-9201 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2020-08-22 |